Since I started yoyo dieting, I've suffered chronic fatigue (Which was significantly worse while losing weight). I've seen *many* doctors about it and nothing has help me a lot. So last week I finally saw an endocrinology to see if this fatigue issue was adrenal, thyroid or metabolism in nature. It took me 20 minutes to make the appt and two months to see her. In the meantime, I practiced my "I'm okay with being fat" speech.
When she came in, she asked what's wrong. I started my speech about being fat and okay. She interrupted me. Her eventual answer to why I am tired was disappointingly typical of medical professionals: because I am depressed and my body is working harder than it should be because I'm fat.
I think that is funny. If my body is working harder because I'm fat, wouldn't I lose weight just from all that hard work? Hard exercise produces endorphins which make you feel *great*, not tired. I think about fat aerobic instructors, I think of weight lifter Cheryl Haworth, I think of my fat friends who seem to have boundless energy. I thought she was ridiculous and won't ever see her again.
The problem is, she seems to be the rule, not the exception. I have long had trouble finding an effective doctor who looks beyond my fat. I've also heard horror stories of doctor's refusing to operate on fat patients (And I'm not talking about knees, I'm talking about life threatening illnesses). There is a lot of bias in medical care. Being treated like dirt will not want to make a person return to the doctor. And being refused to treatment can lead to worsen conditions that would blamed on being fat rather than being refused treatment.
We need bias removed from the medical care. Just because someone is fat, doesn't mean they are ill.
Also in the news, things fat are good for: Protecting you after heart surgery and from Osteoporosis. So if you're thin and have these ailments, gain weight. Gain it right now. What's the matter? No will power?
Or perhaps we need to not dictate a person's size but their general health and well being.
Oh, hon. Just today I had an orthopod tell me that to make my knee pain magically go away all I had to do was lose weight. When I challenged him as to how, he recommended bariatric surgery, but he was also too concerned about 'future damage' if he scoped my knee.
I have arthritis and an almost complete lack of cartilage in *one* knee. If it's fat related, and not related to an old injury to just that knee, why is the other one in so much better shape? That's what I'm going to ask the next doctor who says something like that to me, right before I storm out of his office, too.
Posted by: DataGoddess | June 01, 2009 at 11:31 PM
I have a great endocrinologist, and I've had some other great doctors, so I would say, keep looking.
Posted by: wellroundedtype2 | June 02, 2009 at 12:07 AM
That's awful, and reading about this kind of treatment is depressing. The next time someone starts to tell you it's "because you're depressed", try challenging that with, "Oh really? Could it be because everyone I've seen has refused to actually help me, instead of treating me like any other patient? Or could it be from a multitude of doctors saying that anything wrong with me is my own fault? Maybe it's, in general, depression at a failing medical system where biases hinder doctors from helping the patients who are reaching out to them."
Honestly, what is wrong with these people?
Posted by: Lindsay B. | June 02, 2009 at 03:46 AM
How do they explain depression and fatigue in thin patients, then? Most of the friends I have who are dealing with problems like yours are thin. What diagnosis would this doctor give them?
I'm sorry you're dealing with this. It's awful that we have to be such strong advocates for our own health, but we do. Hang in there. Find another doctor. And if that doesn't work, find another. You deserve it.
Posted by: O.C. | June 02, 2009 at 07:35 AM
I saw an endo last year for an untreated thyroid issue and some other problems and wasted three visits with her for her to tell me "Lose weight." This is, despite the fact that unexplained weight gain was one of my chief symptoms! I then made an appt. with two other endos for the same week (they also had 2-month wait times) in the event that the first endo also sucked. In my case, the first endo was awesome and I canceled my appt. with the second. She saw my weight as a symptom of my thyroid and even then it wasn't really a factor because she ordered a battery of blood work to determine the source of my symptoms and discovered that I am, overall, super-healthy. As it turns out, my thyroid was fine (she did up my dosage of Cytomel) but I was severely deficient in vitamin D and B12. I've been to four other doctors to treat my thyroid -- three family doctors and one endo -- and none ever thought to test me for this despite the fact that I am near vegan. In any case, she prescribed me some supplements and I started feeling reenergized within days. I blogged about it today, in fact.
If I were you, I'd either make an appt. with a new endo or ask the current one to order up a complete round of blood work to test for thyroid, vitamin B12 and D levels, PCOS, adrenals, everything. If it turns out you have hypothyroidism, ask your doctor to also prescribe Cytomel in addition to Synthroid. I had to pay about $200 out of pocket for the tests my doctor ordered but they were totally worth it if just for the sake of knowing.
Posted by: Rachel | June 02, 2009 at 09:38 AM
I have been struggling with chronic fatige for about two years now. I have an excellent GP/PCP and he ordered such a wide range of blood tests that the woman at QWEST looked at me and asked "He wants all these tests?" I think he practically checked every box on the form. She took about eight vials of blood from me.
Those tests reveiled that I have an elevated ANA, which is idicitive of something inflammitory. I have been seeing a rhumetologist for about 4 months. We take lots of blood, nothing is ever remarkable, yet we keep looking. At my last appointment he told me that eventually something will reveal itself. It's nice to have someone take me seriously. In fact during my first visit I told him that I was on anti-depressants and that I had no idea if the fatigue was related to that or something else.
Neither he nor my GP have told me that my issues are weight related. As a matter of fact the rhumetologist is avoiding giving me some meds because weight gain is a side effect. He is also not just throwing drugs at me. He has perscribed nothing. He wants to be sure that what he gives me is apropriate for the problem.
The point? There ARE good doctors out there, you just need to find them. Keep firing the ones that are not good for you until you find "the one". You won't regret it...
Posted by: Catgal | June 03, 2009 at 03:37 PM